mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2023-5-73-78mrj-1480Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL INVESTIGATIONSУратснижающая терапия и риск развития сахарного диабета 2-го типа у пациентов с подагрой (результаты перспективного исследования)Urate-lowering therapy and the risk of developing type 2 diabetes mellitus in patients with gout (results of a prospective study)https://orcid.org/0000-0003-1191-5831ЕлисеевМ. С.EliseevM. S.

Максим Сергеевич Елисеев

115522

Каширское шоссе, 34А

Москва

Maxim Sergeevich Eliseev

115522

34A, Kashirskoe Shosse

Moscow

elicmax@yandex.ruhttps://orcid.org/0000-0002-5394-7869ЖелябинаО. В.ZhelyabinaO. V.

115522

Каширское шоссе, 34А

Москва

115522

34A, Kashirskoe Shosse

Moscow

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation2023171020231757378Copyright © Елисеев М.С., Желябина О.В., 20232023Елисеев М.С., Желябина О.В.Eliseev M.S., Zhelyabina O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://mrj.ima-press.net/mrj/article/view/1480

   Цель исследования – проанализировать связь приема лекарственных препаратов и развития сахарного диабета 2-го типа (СД2) у пациентов с подагрой.

   Материал и методы

   Материал и методы. В исследование включено 444 пациента с подагрой без СД2. Медиана длительности наблюдения – 5,9 [2,9; 8,7] года. Первичная конечная точка – диагноз СД2. Во время стартового визита пациентам назначали или корректировали терапию в соответствии с действующими рекомендациями. Фиксировался прием препаратов: аллопуринола, фебуксостата, диуретиков, глюкокортикоидов (ГК), канакинумаба, для которых было рассчитано отношение шансов (ОШ) развития СД2.

   Результаты и обсуждение. СД2 возник у 108 (24,3 %) из включенных в исследование пациентов. Завершили исследование 405 пациентов. Принимали уратснижающие препараты 311 (76,7 %) больных: 263 (90,7 %) – аллопуринол, 48 (9,3 %) – фебуксостат. Средняя доза аллопуринола – 153,4 ± 28,4 мг/сут, фебуксостата – 91,6 ± 12,1 мг/сут. На фоне терапии фебуксостатом вероятность развития СД2 была ниже: ОШ – 0,433 (95 % доверительный интервал, ДИ 0,188–0,996; р = 0,044). При использовании диуретиков ОШ составило 2,212 (95 % ДИ 1,303–3,753; р = 0,003), ГК – 1,566 (95 % ДИ 1,003–2,445; р = 0,048).

   Заключение

   Заключение. Применение фебуксостата ассоциируется со снижением вероятности развития СД2.

   Objective

   Objective: to analyze the association between medications intake and the development of type 2 diabetes mellitus (T2DM) in patients with gout.

   Material and methods

   Material and methods. The study included 444 patients with gout without T2DM. The median follow-up time was 5.9 [2.9; 8.7] years. The primary end point was the diagnosis of T2DM. At baseline, therapy was initiated or adjusted according to current guidelines. Medication use was recorded: allopurinol, febuxostat, diuretics, glucocorticoids (GC), canakinumab, for which the odds ratio (OR) of developing T2DM was calculated.

   Results and discussion. T2DM occurred in 108 (24.3 %) patients enrolled in the study. 405 patients completed the study. 311 (76.7 %) patients were taking urate-lowering drugs: 263 (90.7 %) allopurinol, 48 (9.3 %) febuxostat. The mean dose of allopurinol was 153.4 ± 28.4 mg/day, and that of febuxostat was 91.6 ± 12.1 mg/day. During treatment with febuxostat, the probability of developing T2DM was lower: OR 0.433 (95 % confidence interval, CI 0.188–0.996; p = 0.044). When diuretics were used OR was 2.212 (95 % CI 1.303–3.753; p = 0.003), GC – 1.566 (95 % CI 1.003–2.445; p = 0.048).

   Conclusion

   Conclusion. Febuxostat use is associated with a lower likelihood of developing T2DM.

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The authors declare that there are no conflicts of interest present.